Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.06 / $103.81 / $185.55	Facility		$74.06	$103.81	$185.55
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $49.00 / $248.24 / $443.70	Facility	25	$49.00	$248.24	$443.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.81 / $84.02 / $180.02	Professional		$47.81	$84.02	$180.02
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $44.16 / $93.28 / $220.00	Professional	25	$44.16	$93.28	$220.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $254.64 / $262.68 / $271.76	Professional	50	$254.64	$262.68	$271.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.48 / $120.55 / $180.72	Professional		$79.48	$120.55	$180.72
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $83.63 / $121.99 / $184.80	Professional	25	$83.63	$121.99	$184.80
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $54.00 / $298.20 / $298.20	Facility		$54.00	$298.20	$298.20
Asuris Northwest Health Facility/Professional Facility Modifier 62 Low / Median / High Price $77.09 / $186.38 / $186.38	Facility	62	$77.09	$186.38	$186.38
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $12.34 / $29.82 / $29.82	Facility	AS	$12.34	$29.82	$29.82
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $86.56 / $165.52 / $567.54	Professional		$86.56	$165.52	$567.54
Asuris Northwest Health Facility/Professional Professional Modifier 25 Low / Median / High Price $82.52 / $123.35 / $196.93	Professional	25	$82.52	$123.35	$196.93
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $99.20 / $116.97 / $143.47	Professional	50	$99.20	$116.97	$143.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $118.05 / $125.00 / $148.00	Facility		$118.05	$125.00	$148.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.57 / $120.49 / $237.45	Professional		$52.57	$120.49	$237.45
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $49.56 / $103.39 / $181.38	Facility		$49.56	$103.39	$181.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $49.76 / $103.00 / $184.53	Professional		$49.76	$103.00	$184.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.45 / $104.72 / $185.15	Professional		$18.45	$104.72	$185.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $96.48 / $150.15 / $182.91	Facility		$96.48	$150.15	$182.91
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $120.50 / $120.50 / $120.50	Facility		$120.50	$120.50	$120.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.81 / $162.94 / $231.87	Professional		$105.81	$162.94	$231.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $89.31 / $140.53 / $207.34	Professional		$89.31	$140.53	$207.34
United Facility/Professional Professional Modifier Low / Median / High Price $77.67 / $117.55 / $244.34	Professional		$77.67	$117.55	$244.34
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $69.11 / $75.92 / $99.89	Professional		$69.11	$75.92	$99.89